Medical billing and collections
Medical billing and collections ensure financial stability. Patient collections bridge gaps, securing payments directly from consumers. This financial stability enables providers to maintain high-quality care, invest in IT and sustain operations, ultimately enhancing patient outcomes and the overall delivery of healthcare services.
Top Stories
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12 Nov 2024
Physician compensation totals 84% of medical group expenses
Medical groups might rethink operations in light of new Kaufman Hall data about physician compensation and overall employee investment/subsidy. Continue Reading
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01 Nov 2024
CMS, CFPB take on improper medical collections in Medicare
CMS and CFPB have issued a joint statement outlining prohibitions against medical debt collection for Medicare members exempt from cost-sharing. Continue Reading
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19 Oct 2023
Generative AI’s Potential Shines on Revenue Cycle Management
Generative AI is making a splash in healthcare, but its strongest use cases may be in revenue cycle management as providers look to streamline administrative tasks. Continue Reading
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17 Oct 2023
Supply Chain Shortages Impact Patient Care and Provider Workflows
Almost half of survey respondents said supply chain shortages have delayed patient care, while a quarter reported medical errors. Continue Reading
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13 Oct 2023
Financial Challenges Drove Healthcare Merger and Acquisition Activity
Nearly 40 percent of transactions in Q3 2023 involved health systems facing financial challenges, a report found. Continue Reading
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11 Oct 2023
High Nursing Home Staff Turnover Yields Poorer Care Quality
A 10-percentage point increase in staff turnover was associated with more health inspection citations and worse quality measures. Continue Reading
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11 Oct 2023
Non-Profit Hospitals Up Community Benefits to $130B
Non-profit hospitals provided $20B more in community benefits in 2020, making up 15.5% of total expenses, AHA reports. Continue Reading
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06 Oct 2023
New Physicians See Plenty of Job Offers but Burnout Impacts Choices
Over 80 percent of new physicians reported experiencing feelings of burnout during their training, which may exacerbate workforce challenges. Continue Reading
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05 Oct 2023
Physician Scheduling Vendors Promise Automation, But Issues Arise
Providers are looking to automate physician scheduling for efficiency and a better experience, but complexities around scheduling are hindering progress. Continue Reading
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04 Oct 2023
75K Kaiser Workers Walk Off in Healthcare’s Largest Strike
Thousands of Kaiser Permanente workers are on strike, pushing for higher wages and more staff to combat persistent clinician burnout and shortages. Continue Reading
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04 Oct 2023
Hospitals See Financial Relief as Revenues Increase, Margins Stabilize
Net operating revenue was up by 8 percent in August, surpassing the 4 percent increase in total expenses and indicating some financial relief for hospitals. Continue Reading
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02 Oct 2023
Workforce Woes Surpass Financial Pressure As Healthcare’s Top Threat
Most healthcare IT leaders and clinicians feel workforce challenges, including clinician burnout, are the top threat to their health systems despite ongoing financial pressure. Continue Reading
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29 Sep 2023
Hospital Finances Stabilize After 6 Months of Positive Margins
Median hospital operating margins rose to 1.4% in August, marking the sixth month of consecutive positive margins for hospitals. Continue Reading
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28 Sep 2023
As Hospitals Consolidate, Medicaid Patients Have Fewer Options
A new research brief finds Medicaid admissions decline as hospital markets get more concentrated, but hospitals question the analysis. Continue Reading
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28 Sep 2023
Navigating the Impact of Rising Healthcare Costs on Patient Finances
Rising healthcare costs are straining patient finances, highlighting the need for flexible financial solutions to address a growing problem. Continue Reading
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26 Sep 2023
Healthcare CFOs Concerned About Economy, Regulations
A survey of healthcare CFOs finds that the current economic environment is the top organizational concern, followed by new regulatory requirements and cost structure. Continue Reading
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20 Sep 2023
Only 19% of Nursing Homes Currently Meet Proposed Staffing Standards
Over 80 percent of nursing homes would have to hire more registered nurses and nurse aides to comply with the proposed staffing standards. Continue Reading
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19 Sep 2023
Hospital Prices Online Are Not Aligned With Prices Offered via Telephone
The difference between hospital prices posted online and those provided via telephone for a brain MRI was 50 percent or more at 12 hospitals. Continue Reading
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18 Sep 2023
Oracle Adds Healthcare Capabilities to ERP, Supply Chain Products
The IT company that bought Cerner said the new capabilities will help healthcare organizations cut costs, increase productivity, and embrace new business models, among other benefits. Continue Reading
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18 Sep 2023
Dana-Farber, Beth Israel Team Up To Create a Cancer Hospital
The new partnership signals an eventual end of the Brigham and Women’s Hospital affiliation as the cancer institute collaborates with its competitor. Continue Reading
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06 Sep 2023
As PCPs Integrate With Health Systems, Steering Increases Costs
A new study of vertical integration in healthcare shows PCPs in health systems steer patients toward systems and specialists, resulting in higher utilization and costs. Continue Reading
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05 Sep 2023
CMS Proposes Minimum Staffing Standards for Nursing Homes
The minimum staffing standards would require nursing homes to have a registered nurse onsite at all times to provide direct resident care. Continue Reading
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05 Sep 2023
1 in 3 Healthcare Workers Plan to Leave Their Position, Survey Finds
Healthcare workers are experiencing anxiety, depression, and exhaustion, prompting them to leave their jobs. Continue Reading
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31 Aug 2023
Hospital Financial Performance Continued Downward Trend in July
Expenses fell from June to July but not by enough to offset revenue losses, contributing to poor hospital financial performance. Continue Reading
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30 Aug 2023
Key Ways to Boost Collection of Patient Financial Responsibility
How can healthcare providers redesign their medical billing processes to account for the steep rise in patient financial responsibility? Continue Reading
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28 Aug 2023
Allina Health Ends Medical Billing Practice Based on Past-Due Debt
The decision follows the Minnesota Attorney General’s announcement to investigate the nonprofit health system’s medical billing practice. Continue Reading
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28 Aug 2023
Private Equity Acquisitions Come with Growing Antitrust Concerns
As antitrust agencies ramp up their scrutiny of private equity acquisitions, physician practices should prepare for potential investigations before getting involved with firms. Continue Reading
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28 Aug 2023
How Practices Can Avoid Overlooked Revenue Opportunities
Providers are leaving money on the table, but a tighter revenue cycle and technology can help practices identify and close gaps. Continue Reading
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24 Aug 2023
Hospitals, Health Systems Recognized for Price Transparency Compliance
The hospitals and health systems receiving awards have complied with price transparency regulations, including publishing machine-readable files with standard charges. Continue Reading
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23 Aug 2023
Healthcare's Interest in Private Credit, Other Funding Sources Grows
Private equity's reach in healthcare has been a topic of interest lately, but more providers are looking to private credit lenders and other funding sources for growth capital. Continue Reading
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22 Aug 2023
Middle-Class Americans Face Highest Rates of Medical Debt Burden
Almost a quarter of middle-class Americans had medical debt, compared to 22 percent of lower-class people and 13 percent of higher-class people. Continue Reading
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21 Aug 2023
OHSU, Legacy Health Sign Letter of Intent to Form Integrated Health System
With more than 32,000 employees, the integrated health system would be the largest employer in the Portland metro area. Continue Reading
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11 Aug 2023
HRSA Grants $100M to Improve Nursing Workforce as Shortages Persist
Grant recipients include programs that prioritize training and educating the future and current nursing workforce. Continue Reading
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09 Aug 2023
Independent Hospital Acquisitions Tied to Higher Healthcare Prices
Average healthcare prices for commercially insured patients increased by 5 percent following independent hospital acquisitions. Continue Reading
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09 Aug 2023
Hospital-Owned Practices Pull Ahead, But Staffing Shortages Ding All
Hospital-owned practices report year-over-year increases in medical revenue as physician-owned practices face cuts, but staffing shortages are catching up to all. Continue Reading
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08 Aug 2023
Private Equity in Healthcare Is Under A Microscope, So What’s Next?
A study reveals harmful impacts of private equity in healthcare as lawmakers debate its role, but investments aren’t likely to slow down soon. Continue Reading
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03 Aug 2023
Hospital Margins Aren’t Budging, Raising Concerns About Care
Hospital operating margins improved slightly in June, but persistent economic challenges worry leading hospital groups. Continue Reading
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28 Jul 2023
Two Years In, Hospital Price Transparency Compliance at 36%
The hospital price transparency rule sees only 721 hospitals in compliance, while a staggering 64 percent still lag. Continue Reading
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25 Jul 2023
Nurses, Physicians Say Health Insurer Policies Restrict Access to Care
Increasingly restrictive health insurer policies, like prior authorization, impact nurses’ and physicians’ abilities to deliver patient care. Continue Reading
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25 Jul 2023
Physician Turnover Trends Up, But Not As Bad As Expected During COVID-19
A new method for measuring physician turnover shows more doctors leaving and moving since 2010, with rates evening out by 2020. Continue Reading
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24 Jul 2023
Study: Hospital Bottom Lines Better Than Depicted During COVID-19
A new study finds only 16% of hospitals had PHE financial distress despite claims of widespread hospital financial troubles during the COVID-19 pandemic. Continue Reading
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20 Jul 2023
Key Types of Revenue Cycle Technology That Optimize Operations
Revenue cycle technology takes many shapes and sizes depending on a provider’s need, but the tools have become essential to smooth revenue cycle operations. Continue Reading
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19 Jul 2023
Providers Are Outsourcing Revenue Cycle Services Amid Workforce Shortages
When outsourcing revenue cycle management services, providers want vendors that are transparent, accessible, and accurate. Continue Reading
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18 Jul 2023
Q2 2023 Hospital Merger and Acquisition Activity Hit Pre-Pandemic Levels
Hospital merger and acquisition activity in Q2 2023 surpassed levels seen in 2019 and 2020, the report found. Continue Reading
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18 Jul 2023
The Next Step in UnityPoint Health’s Revenue Cycle Technology Journey
UnityPoint Health is moving from automation to machine learning and patient-facing tech as the health system’s revenue cycle technology journey continues. Continue Reading
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17 Jul 2023
AMA: Physicians Have Moved from Private to Hospital-Owned Practices
More physicians are working at hospital-owned practices as they want better chances to negotiate favorable payment rates with payers. Continue Reading
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17 Jul 2023
How to Establish a Proactive Revenue Cycle Strategy
Revenue cycle strength depends on a proactive strategy that incorporates KPIs, benchmarking, and regular performance reviews. Continue Reading
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13 Jul 2023
HHS Investigates Medical Credit Cards, Installment Loans
HHS is joining other federal departments to investigate if medical credit cards and installment loans drive up healthcare costs and medical debt. Continue Reading
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13 Jul 2023
Medical Debt Unevenly Impacts People of Color, Low-Income Residents in NY
Consumers in New York with a median household income of less than $54,200 were three times more likely to have medical debt than those with incomes above $88,500. Continue Reading
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12 Jul 2023
Private Equity Acquisitions Led to Higher Prices at Physician Practices
In addition to price increases, private equity acquisitions were tied to higher spending per patient at physician practices. Continue Reading
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06 Jul 2023
MGMA: Nursing Compensation Increases as Staffing Challenges Continue
Medical groups are increasing compensation and bonuses for nurses to help combat staffing challenges and improve recruitment and retention. Continue Reading
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05 Jul 2023
FTC Proposes Merger Review Changes that Could Impact Healthcare Deals
The changes would require entities involved in healthcare deals and other mergers to submit additional information for competition reviews. Continue Reading
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30 Jun 2023
Primary Care Compensation Growth Surpassed Other Specialties in 2022
Primary care compensation increased by 6.1 percent, while compensation grew by 1.5 percent for medical specialties and 1.6 percent for surgical specialties. Continue Reading
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28 Jun 2023
Hospital Finances Stabilized as Revenues Grew, Expenses Fell
Outpatient services drove revenue growth in May, helping hospital finances stabilize. Continue Reading
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27 Jun 2023
Negotiated and Cash Prices are Lower at Physician-Owned Hospitals
Median commercial negotiated prices and cash prices were up to 33 percent and 36 percent lower at physician-owned hospitals. Continue Reading
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26 Jun 2023
Optum to Acquire Home Health, Hospice Provider Amedisys
The bidding war ends as Amedisys announces its intention to combine with Optum over Option Health Care, Inc. Continue Reading
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26 Jun 2023
Interest Rates, Recession Fears Aren’t Stopping Healthcare Deals
PwC remains optimistic about healthcare deals through the rest of 2023 despite strong headwinds, including high interest rates and general recessionary fears. Continue Reading
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23 Jun 2023
Hospital Consolidation Tied to Loss of Inpatient Pediatric Services
Policymakers should consider the impact of hospital consolidation on inpatient pediatric services when evaluating proposed mergers and acquisitions, researchers said. Continue Reading
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22 Jun 2023
UPMC, Washington Health System Sign Letter of Intent to Affiliate
After decades of collaboration between the organizations, the letter of intent establishes plans for Washington Health System to integrate into the UPMC system. Continue Reading
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21 Jun 2023
KLAS Report Shares Top Outsourcing Firms for Healthcare Coding Services
Oxford Global Resources and Ciox Health were the top outsourcing firms larger healthcare organizations used for coding services. Continue Reading
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19 Jun 2023
AMA Opposes Non-Compete Agreements for Hospital-Employed Physicians
Non-compete agreements can also limit career opportunities for residents in graduate medical education (GME) programs, AMA said. Continue Reading
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15 Jun 2023
AHA Condemns FTC’s Unconstitutional Antitrust Enforcement Practices
FTC’s antitrust enforcement practices used in Illumina Inc. v FTC are unconstitutional and disproportionately impact hospital mergers, AHA said. Continue Reading
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14 Jun 2023
Healthcare Spending to Pick Up Pace, Reaching $7.2T by 2031
National healthcare spending growth is stabilizing after COVID-19, but the feds expect the rate to accelerate to 5.4% per year through 2031. Continue Reading
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13 Jun 2023
Rising Expenses May Jeopardize Hospitals’ Financial Stability
Total expenses increased year-over-year for the twelfth consecutive month, driven by high labor expenses for nurses. Continue Reading
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12 Jun 2023
AMA: US Healthcare System Headed for Success After 2022 Hurdles
Prior authorization reform and Medicare payment legislation will help the nation’s healthcare system recover from previous administrative challenges, the AMA president said. Continue Reading
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08 Jun 2023
AHA: Health Insurer Policies Fuel Physician Practice Acquisitions
The growing number of physician practice acquisitions may reflect the high administrative burden on physicians resulting from health insurer policies, such as prior authorization requirements. Continue Reading
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07 Jun 2023
Nonprofit Hospitals Offer Less Charity Care Despite Rising Profits
From 2012 to 2019, profits increased from $43.01 million to $58.61 million for nonprofit hospitals, while charity care spending fell from $6.65 million to $6.36 million. Continue Reading
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05 Jun 2023
BJC, Saint Luke’s Announce Plans to Form Integrated Health System
The integrated health system will serve over 6 million patients in Missouri, Illinois, and Kansas. Continue Reading
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05 Jun 2023
How to Maximize Revenue Cycle Strategy for Financial Success
Defining goals, reviewing policies, and optimizing the billing team are some of the ways providers can maximize revenue cycle strategy. Continue Reading
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31 May 2023
Hospital Finances Break Even as PHE Ends, Medicaid Unwinds
Kaufman Hall reports the median year-to-date operating margin index for hospitals was 0.0% in April when the COVID-19 PHE and many of its flexibilities ended. Continue Reading
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31 May 2023
Clinic Staffing Costs Up 10% This Year
Despite a stabilization of overall finances, clinic staffing costs continue to rise amid healthcare labor shortages, according to AMGA. Continue Reading
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30 May 2023
Quality, Costs of Care Similar Between DOs and MDs
Hospitalized elderly patients treated by DOs had similar rates of mortality and hospital readmission compared to those treated by MDs, according to a new study. Continue Reading
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30 May 2023
Private Equity Firm Invests in RCM Company Alpha II
Global private equity firm TA Associates has signed a definitive agreement to make a growth investment in Alpha II, an RCM company focused on coding optimization. Continue Reading
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26 May 2023
Physician Compensation, Productivity Grew in 2022 Despite Shortages
Increases in physician compensation ranged from 0.13 percent for urgent care providers to 10.57 percent for family medicine physicians. Continue Reading
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22 May 2023
Aspirion Acquires Revenue Cycle Management Company FIRM
Tech-enabled revenue cycle management company Aspirion has made its sixth purchase over the last five years, this time scooping up FIRM RCM. Continue Reading
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19 May 2023
KLAS Shares User Reviews of Computer-Assisted Coding Vendors
Computer-assisted coding vendor Dolbey received overall positive reviews, while customer feedback for Optum and 3M was mixed. Continue Reading
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18 May 2023
Racial and Ethnic Health Inequities Led to $421B in Excess Spending
Two-thirds of the economic burden of racial and ethnic health equities was attributable to premature death, the study found. Continue Reading
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17 May 2023
AMA: 31% of Physicians Have Faced Medical Liability Claims
Physicians over 54 and those in surgical specialties were most likely to face medical liability claims during their career, according to AMA’s analysis. Continue Reading
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16 May 2023
Key Ways the Debt Ceiling Impacts Healthcare Providers, Payments
Patient access to care and healthcare reimbursement are on the line as lawmakers negotiate a debt ceiling agreement. Continue Reading
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16 May 2023
Physician Staffing Firm Envision Healthcare Files for Bankruptcy
Envision Healthcare officially filed for bankruptcy after the WSJ reported the physician staffing firm had over $7B in outstanding debt and labor woes. Continue Reading
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15 May 2023
More Nurses to Leave Healthcare Workforce as Job Satisfaction Drops
Three in ten nurses said they will likely leave the healthcare workforce due to the pandemic, up from 23 percent in 2021. Continue Reading
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11 May 2023
What the End of the COVID-19 PHE Means for Healthcare Providers
With the COVID-19 public health emergency over, healthcare providers must learn to navigate financial and operational challenges without certain waivers and flexibilities. Continue Reading
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11 May 2023
Hospital Revenue Growth Outpaced Rising Expenses in March
Total expenses increased by 8.3 percent from February to March 2023, but gross operating revenue grew by 12.5 percent over the same time. Continue Reading
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08 May 2023
CFPB Report Identifies Pitfalls of Medical Credit Cards, Loans
Medical credit cards and loans from financial institutions and fintech companies come with high interest rates and confusing terms, leading to more patient financial stress. Continue Reading
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08 May 2023
Hospital-Physician Integration Leads to More Intense Cardiac Care
A new study links hospital-physician integration to more intense, hospital-based coronary interventions, which come with more risk to patients. Continue Reading
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04 May 2023
Razor Thin Margins Leave Hospitals Vulnerable to a Recession
Hospital margins are stabilizing but remain below pre-pandemic levels, making hospitals and health systems vulnerable to a possible recession or public health emergency. Continue Reading
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03 May 2023
Private Equity Firms Acquired Over 700 Oncology Practices in 20 Years
In seven states, more than 25 percent of oncology practices were affiliated with private equity firms, the study found. Continue Reading
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01 May 2023
Intermountain Taps Surgery Partners to Manage, Grow ASCs
Surgery Partners will take over management of Intermountain’s ambulatory surgery centers (ASCs) in Utah and Idaho, while developing more in other markets. Continue Reading
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28 Apr 2023
Skilled Nursing Facility Use Increased Following PHE Waiver
The share of skilled nursing facility episodes without preceding hospitalization increased from 6 percent to 32 percent during the COVID-19 pandemic due to the CMS public health emergency waivers. Continue Reading
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27 Apr 2023
Kaiser Permanente to Acquire Geisinger, Expand Value-Based Care
Kaiser Permanente has agreed to acquire PA-based Geisinger Health in a bid to expand value-based care under Risant Health, a new nonprofit group. Continue Reading
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26 Apr 2023
Nonprofit Hospitals Rely on Financial Reserves Amid Operational Challenges
Financial reserves can help nonprofit hospitals maintain staffing, fund capital projects, and increase their debt capacity. Continue Reading
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25 Apr 2023
More Medical Liability Premiums Increased in 2022, AMA Finds
Medical liability premiums grew by 10 percent or more in 15 states, with Kansas seeing the greatest increase of 40.9 percent. Continue Reading
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24 Apr 2023
Uncompensated Care, Area Disadvantage Impair Safety-Net Margins
A new study ties higher levels of uncompensated care and area disadvantage to low safety-net hospital margins versus providing more essential services or being a critical access hospital. Continue Reading
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24 Apr 2023
AHA: Financial Challenges Continue as Hospital Expenses Rise
Hospital expenses increased by 17.5 percent between 2019 and 2022, and AHA expects this trend to continue in 2023 without congressional action. Continue Reading
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20 Apr 2023
Price Transparency Rule Compliance is Growing But Needs More Oversight
Over 84 percent of hospitals are complying with the price transparency rule, but more oversight from CMS could reduce confusion for consumers and improve compliance. Continue Reading
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20 Apr 2023
Revenue Cycle Leaders Spend the Most Time on Denials Management
Over 75 percent of revenue cycle leaders said denials management—a costly process that can adversely impact patient experience—was the most time-consuming task for their organization. Continue Reading
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19 Apr 2023
Physician Compensation Rises 17% Since 2018 as Shortages Persist
The gender pay gap is also closing, with female primary care physicians earning 19% less and specialists 36% less, according to Medscape’s latest Physician Compensation Report. Continue Reading
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19 Apr 2023
900K Registered Nurses Expected to Leave Workforce by 2027
Most registered nurses said they plan to leave the healthcare workforce because of stress, burnout, and retirement. Continue Reading
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17 Apr 2023
Froedtert Health, ThedaCare Announce Merger Plans
The Wisconsin-based health systems signed a letter of intent to merge into one organization after years of partnership, including a joint venture to create two new health campuses. Continue Reading
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17 Apr 2023
Q1 2023 Healthcare Merger and Acquisition Activity Generated $12.4B
Several healthcare mergers and acquisitions were cross-regional transactions and included mid-size health systems in the first quarter of 2023. Continue Reading
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13 Apr 2023
Hospital, Registered Nurse Turnover Rates Remained High in 2022
The average cost of a registered nurse turnover was $52,350, leading the average hospital to lose $8.55 million in 2022. Continue Reading
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13 Apr 2023
Tax Breaks Exceeded Charity Care Spending for Nonprofit Hospitals
The $14.2 billion total fair share deficit was enough to erase the medical debt of 18 million Americans or save 600 at-risk hospitals from closing, the report found. Continue Reading